第三大臼歯手術中に発現した広範な皮下気腫を伴う両側気胸。症例報告

Bilateral pneumothorax with extensive subcutaneous emphysema manifested during third molar surgery. A case report.

抄録

本報告では、エアタービン歯科用ハンドピースを用いた左下第三大臼歯の抜歯手術中に発生した、広範な皮下気腫を伴う両側気胸の症例（45歳男性）について述べる。コンピュータ断層撮影では、頸顎顔面領域および解剖学的深部腔（翼突顎腔、傍咽頭腔、後咽頭腔、側頭深部を含む）から胸部前壁まで両側性に広がる重度の皮下気腫が認められた。さらに、両側気胸と気中隔が認められた。私たちの患者では、おそらく加圧された空気が手術部位から周囲の結合組織に押し込まれたために、気切が生じたのであろう。

This report describes a case of bilateral pneumothorax with extensive subcutaneous emphysema in a 45-year-old man that occurred during surgery to extract the left lower third molar, performed with the use of an air turbine dental handpiece. Computed tomographic scanning showed severe subcutaneous emphysema extending bilaterally from the cervicofacial region and the deep anatomic spaces (including the pterygomandibular, parapharyngeal, retropharyngeal, and deep temporal spaces) to the anterior wall of the chest. Furthermore, bilateral pneumothorax and pneumomediastinum were present. In our patient, air dissection was probably caused by pressurized air being forced through the operating site into the surrounding connective tissue.